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Legislative Update

Update of ACA Legislative Activities Regarding Medicare and Managed Care Reform


As reported earlier, the ACA has developed a legislative strategy that will protect chiropractic patients in the new Medicare+Choice program, as well as increasing the scope of practice for doctors of chiropractic in the Medicare Part B program. This strategy includes the introduction of the Chiropractic Patients' Freedom of Choice Act (H.R. 1046), which would provide reimbursement for all physician services for doctors of chiropractic, within the scope of their license, under the Medicare program. Since its introduction on March 10, 1999, H.R. 1046 has received strong bipartisan support in the House of Representatives -- 33 cosponsors and growing.

The second phase of the ACA Medicare strategy includes the introduction of two Concurrent Resolutions, H.Con.Res. 62 by Representative Cubin (R-WY) on March 18, 1999 and S.Con.Res 32 by Senator Conrad (D-ND) on May 17, 1999. These resolutions express the sense of Congress that treatment by means of manual manipulation of the spine to correct a subluxation is a uniquely chiropractic service and that it is the unequivocal intent of Congress that this service should be guaranteed for beneficiaries in the new Medicare+Choice program. These resolutions will support the ACA's lawsuit by expressing the congressional intent, in legislative form, that chiropractic services do exist in Medicare and that beneficiaries in managed care plans should have the ability to choose treatment by a doctor of chiropractic, as do those in Medicare Part B. The Congressional support for these concurrent resolutions is growing -- H.Con.Res. 62 has 14 cosponsors and S.Con.Res. 32 has 4 cosponsors.

If you have not already done so, it is imperative that you call or write your Representative and Senators immediately and ask that they cosponsor H.R. 1046 and H.Con.Res. 62 in the House and S.Con.Res. 32 in the Senate. For Issue Briefs and sample letters regarding these issues, please see the Government Relations section of the ACA website "".

Managed Care Reform

The debate in Congress over comprehensive managed care reform legislation is not as clear cut as it was last year. Numerous bills have been introduced by both Republicans and Democrats, some very comprehensive and some very narrow in scope. To complicate the matter, the issue of managed care reform has become very partisan. In the Senate, two bills have emerged as the front runners, S. 326 (supported by the Republican Leadership) and S. 6 (supported by the Democratic Leadership). The ACA is actively working on the inclusion of strong anti-discrimination for providers language in both of these bills, but the timing of final consideration of either bill is unclear. Because of the possibility of a filibuster, neither bill will be considered without a compromise from both sides.

In the House, the Republicans have taken a two-track approach in developing managed care reform legislation. As earlier reported, Representative Thomas Bliley (R-VA), Chairman of the House Commerce Committee, requested Representative Norwood (R-GA), Representative Ganske (R-IA), and Representative Coburn (R-OK) develop a "consensus bill" that would be used as a model for managed care reform. During this process, the ACA has been working with proponents of the bill for the inclusion of provisions that would be beneficial to the chiropractic profession. It has been reported to the ACA that the Commerce Committee will complete work on this "consensus bill" in July. The House Education and the Workforce Committee is also working on managed care reform legislation. This legislation is very similar to the "so-called" patient protection bill that passed the House last year, which the ACA strongly opposed. It has been reported to the ACA that the Republican Leadership may use the legislation developed by the Education and the Workforce Committee as the basis of the final legislation that will be voted on in the House.

Although the outcome of the managed care reform debate in Congress is unclear, the ACA will continue to work for the inclusion of pro-chiropractic provision in whatever legislation is considered in either the House or Senate. The ACA will keep you apprised of any developments and will alert you when grassroots action is needed.

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